Left ventricular non-compaction cardiomyopathy and left ventricular assist device: a word of caution

• Published in: Journal of cardiothoracic surgery Vol. 11; no. 1; p. 108
• Main Authors: Kornberger, A, Stock, U A, Risteski, P, Beiras Fernandez, A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.07.2016; BioMed Central
• Subjects: Adult; Cardiomyopathies - complications; Cardiomyopathies - physiopathology; Cardiomyopathies - surgery; Care and treatment; Case Report; Case studies; Diagnosis; Echocardiography; Health aspects; Heart assist devices; Heart Failure - etiology; Heart Failure - physiopathology; Heart Failure - surgery; Heart Transplantation; Heart Ventricles - physiopathology; Heart Ventricles - surgery; Humans; Male; Myocardial diseases; Myocardium; Germany; Left ventricular assist device; Inflow obstruction; Left ventricular non-compaction; Heart transplantation
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-016-0503-2

In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge. We report a patient with LVNC who required urgent heart transplantation for inflow cannula obstruction nine months after receiving a LVAD. LVAD parameters, echocardiography and examination of the explanted heart suggested changes of left ventricular configuration brought about by LVAD support as the most likely cause of inflow cannula obstruction. We conclude that changes experienced by non-compacted myocardium during LVAD support may give rise to inflow cannula obstruction and flow reduction. Presence of LVNC mandates tight surveillance for changes in LV configuration and LVAD flow characteristics and may justify urgent transplantation listing status.